(Stool Soiling; Fecal Incontinence; Soiling, Stool)
Encopresis is the passage of stool in places other than the toilet. It is often an involuntary action. Encopresis is often called stool soiling because of the stains left on underwear.
Accidents are normal in infants and toddlers until they learn bowel control. It is considered stool soiling in children aged four years and older.
Encopresis may be caused by a variety of conditions such as:
Risk factors include:
The main symptom is the accidental passage of stool, usually into the underwear. Other symptoms may include:
If associated with constipation your child may have:
When Should I Call the Doctor?
Call the doctor if your child has stool staining in his underwear. The doctor can help find the underlying cause.
The doctor will ask about your child's symptoms and medical history. A physical exam will also be done.
Parents are often unaware that their child is constipated. However, they may see their child forcibly holding stool when he has the urge to move his bowels. Your child may also be unwilling to use the toilet in certain locations. These description of stool holding is important for the doctor to know about.
To make a diagnosis, the doctor may order tests, such as:
Treatment will depend on the cause of soiling. As a parent, it is important that you do not shame your child. Some treatment options include:
Enemas and laxatives may be recommended if constipation is a problem. It will help to clean out your child's bowel. These treatments are only used short term. If the constipation is not relieved or if your child passes blood with their stool, further testing may be done. This will help to find the cause of the constipation.
Your doctor may recommend miralax or other stool softener. This can make it easier for your child to pass stool. It may decrease your child's reluctance to pass stool.
Some constipation can be prevented through simple dietary changes. To help prevent constipation, encourage your child to:
Help your child learn when to use the toilet. For example, encourage your child to go to the bathroom at certain times during the day.
Keep positive. Consider rewards for your child for keeping their clothes clean and using the toilet.
Counseling may be needed if your child:
Following guidelines for toilet training may help prevent encopresis. A healthy, high-fiber diet and adequate liquid intake may also help prevent this condition.
American Academy of Family Physicians
National Digestive Diseases Information Clearinghouse
Canadian Digestive Health Foundation
Encoporesis. Nemours kids health website. Available at: http://kidshealth.org/parent/general/sick/encopresis.html . Updated January 2012. Accessed August 9, 2012.
Fecal soiling. American Academy of Pediatrics Helath Children website. Available at: http://kidshealth.org/parent/general/sick/encopresis.html . Updated May 2011. Accessed August 9, 2012.
Fecal incontinence in children (encopresis). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . May 11, 2012. Accessed August 9, 2012.
Stool soiling and constipation in children. American Family Physician Family Doctor website. Available at: http://familydocto... . Updated November 2011. Accessed August 9, 2012.
Last reviewed September 2012 by Michael Woods